Guidewire Breakage during Neurointerventional Procedures: a Report of Two Cases

We report on two cases of microguidewire breakage that occurred during endovascular treatment of intracranial aneurysms. The microguidewire can be broken when a part of the wire is stuck due to vascular tortuosity, and, subsequently, application of excessive rotational movement. The mechanical and physical properties of a microguidewire are also important factors in microguidewire breakage. We also suggest technical tips for avoidance of this problem

Value of Manganese-Enhanced T1- and T2-Weighted MR Cholangiography for Differentiating Cystic Parenchymal Lesions from Cystic Abnormalities which Communicate with Bile Ducts

We present a case report to show how manganese-enhanced T1- and T2-weighted MR cholangiography could differentiate cystic parenchymal lesions from cystic abnormalities which communicate with the bile ducts

Assessment of the Prognostic Factors for a Local Recurrence of Rectal Cancer: the Utility of Preoperative MR Imaging

OBJECTIVE: To determine the utility of MR imaging in evaluating the prognostic factors for a local recurrence of rectal cancer following a curative resection. MATERIALS AND METHODS: The preoperative MR images obtained from 17 patients with a local recurrence and 54 patients without a local recurrence, who had undergone a curative resection, were independently evaluated by three radiologists. The following findings were analyzed: the direct invasion of the perirectal fat by the primary rectal carcinoma, involvement of the perirectal lymph nodes, perirectal spiculate nodules, perivascular encasement, and an enlargement of the pelvic wall lymph nodes. The clinical and surgical profiles were obtained from the patients' medical records. The association of a local recurrence with the MR findings and the clinicosurgical variables was statistically evaluated. RESULTS: Of the MR findings, the presence of perivascular encasement (p = 0.001) and perirectal spiculate nodules (p = 0.001) were found to be significant prognostic factors for a local recurrence. Of the clinicosurgical profiles, the presence of a microscopic vascular invasion (p = 0.005) and the involvement of the regional lymph nodes (p = 0.006) were associated with a local recurrence. Logistic regression analysis showed that the presence of perirectal spiculate nodules was an independent predictor of a local recurrence (odds ratio, 7.382; 95% confidence interval, 1.438, 37.889; p = 0.017). CONCLUSION: The presence of perirectal spiculate nodules and perivascular encasement on the preoperative MR images are significant predictors of a local recurrence after curative surgery for a rectal carcinoma. This suggests that preoperative MR imaging can provide useful information to help in the planning of preoperative adjuvant therapy.ope

Use of Nafamostat Mesilate as an Anticoagulant during Extracorporeal Membrane Oxygenation

Although the incidence of bleeding complications during extracorporeal membrane oxygenator (ECMO) support has decreased in various trials, bleeding is still the most fatal complication. We investigated the ideal dosage and efficacy of nafamostat mesilate for use with ECMO in patients with acute cardiac or respiratory failure. We assessed 73 consecutive patients who received ECMO due to acute cardiac or respiratory failure between January 2006 and December 2009. To evaluate the efficacy of nafamostat mesilate, we divided the patients into 2 groups according to the anticoagulants used during ECMO support. All patients of nafamostat mesilate group were male with a mean age of 49.2 yr. Six, 3, 5, and 3 patients were diagnosed with acute myocardial infarction, cardiac arrest, septic shock, and acute respiratory distress syndrome, respectively. The mean dosage of nafamostat mesilate was 0.64 mg/kg/hr, and the mean duration of ECMO was 270.7 hr. The daily volume of transfused packed red blood cells, fresh frozen plasma, and cryoprecipitate and the number of complications related to hemorrhage and thrombosis was lower in the nafamostat mesilate group than in the heparin group. Nafamostat mesilate should be considered as an alternative anticoagulant to heparin to reduce bleeding complications during ECMO

Mucosa-Associated Lymphoid Tissue Lymphoma of the Esophagus Coexistent with Bronchus-Associated Lymphoid Tissue Lymphoma of the Lung

Non-Hodgkin's lymphoma very rarely involves the esophagus, occurring in less than 1% of patients with gastrointestinal lymphoma. A few cases of mucosa-associated lymphoid tissue (MALT) lymphoma of the esophagus have been reported in the English literature. To our knowledge, there has been no report of MALT lymphoma of the esophagus coexistent with bronchus-associated lymphoid tissue lymphoma (BALT) of the lung. This report details the radiological and clinical findings of this first concurrent case

Gadobenate Dimeglumine as an Intrabiliary Contrast Agent: Comparison with Mangafodipir Trisodium with Respect to Non-dilated Biliary Tree Depiction

OBJECTIVE: To compare the efficacy of Mangafodipir trisodium (Mn-DPDP)-enhanced MR cholangiogrphy (MRC) and Gadobenate dimeglumine (Gd-BOPTA)-enhanced MRC in visualizing a non-dilated biliary system. MATERIALS AND METHODS: Eighty-eight healthy liver donor candidates underwent contrast-enhanced T1-weighted MRC. Mn-DPDP and Gd-BOPTA was used in 36 and 52 patients, respectively. Two radiologists reviewed the MR images and rated the visualization of the common duct, the right and left hepatic ducts, and the second-order branches using a 4-point scale. The contrast-to-noise ratio (CNR) of the common duct to the liver in the two groups was also compared. RESULTS: Mn-DPDP MRC and Gd-BOPTA MRC both showed similar visualization grades in the common duct (p=.380, Mann-Whitney U test). In the case of the proximal bile ducts, the median visualization grade was significantly higher with Gd-BOPTA MRC than with Mn-DPDP MRC (right hepatic duct: p=0.016, left hepatic duct: p=0.014, right secondary order branches: p=0.006, left secondary order branches, p=0.003). The common duct-to-liver CNR of the Gd-BOPTA MRC group was significantly higher (38.90+/-24.50) than that of the Mn-DPDP MRC group (24.14+/-17.98) (p=.003, Student's t test). CONCLUSION: Gd-BOPTA, as a biliary contrast agent, is a potential substitute for Mn-DPDP.ope